Health commissioner raises revision of EU treaties

European commissioner for health Vytenis Andriukaitis wants to talk about expanding the role of the EU in health policy.

“I believe it will be nice to discuss the possibility to change the European Union treaties in the future,” Andriukaitis told a crowd of pharma lobbyists and policy makers at a conference in Riga on Monday, after POLITICO asked him whether the current Commission is taking a different direction in health policy.

As it stands now, the treaties give a limited EU role in setting health policy in member states. In EU speak, the EU has “supporting competences” in the area. For example, one of the areas that is still firmly in the hands of member states is the setting the price of a drug in negotiations with drugmakers.

Andriukaitis wants to see if there is an appetite to enshrine a larger role of the EU in health policy in the treaties.

While now the EU can work on prevention-type issues such alcohol and tobacco, the treaties could cover broader ideas, he said. “I think it will be very timely to raise those questions” with the European Parliament and the Council of the EU, he added.

“Believe me, I can’t imagine a more economically effective possibility than to manage health issues at EU level,” said Andriukaitis.

Despite the comments, there are no signs of a big movement afoot to make changes to EU treaties, which would be a major endeavor.

The Commissioner also proposed preparing and presenting reports on the state of health in each member state to the European Parliament. Such reports could be developed by the Commission over two or three years, he added. He later told POLITICO to wait for more news on this, later this summer.

Jo De Cock, general administrator of the Belgian social security body, said that the EU could do more in the area of access to pharmaceuticals.

“We are in favor of having an integrated approach” not only on market authorization, already a clear EU competence; not only on assessing new drugs and devices, but also on pricing by scanning the horizon for what other drugs will be out there in the future, he said. De Cock also wants EU countries to cooperate on drug pricing, as “[t]his is not business as usual.”

The Belgians are currently talking with the Dutch (and possibly the Luxembourgers) about teaming up to negotiate prices with drugmakers and jointly look ahead to future medicines hitting the market.

“The high cost of medicines is the elephant in the room that nobody wants to talk about,” said Yannis Natsis from the NGO Trans Atlantic Consumer Dialogue.

“The Belgian initiative by Mr. De Cock is welcome as long as it moves towards shedding more light into the industry black box of price setting,” added Natsis.

Pharmaceutical costs are a hot topic among European policymakers, with drugmakers demanding precedent-setting and budget-busting prices for some medicines with potentially big markets.

First, Alexion, the company that makes the pricey drug Soliris, made noise in Belgium for using questionable PR tactics to get public coffers to pay for the drug, called by some as the most expensive drug in the world.

And throughout the year, the $1,000-per-pill drug Sovaldi had led purchasers to complain about price gouging.

The EU role in pharmaceutical policy is now largely one of approval and safety monitoring. The UK-based European Medicines Agency can clear new medicines throughout the union.

But states have kept and some prize their sovereignty over pricing.

The pharmaceutical industry’s main lobbying group says member states should keep their powers.

“Prices in different countries will vary in order to reflect differences in the burden of disease, indications, health system preferences and ability to pay, patterns of medicines usage, market structures, and also distribution-chain related components,” Elizabeth Kuiper from EFPIA said.

Another Commission official said there is room for change, perhaps slowly.

“So far we have been trying not to go to pricing and reimbursement,” Andrzej Rys, a director in DG Sante of the European Commission said. “It’s a quite tricky question.” The Commission will be discussing this with the Council on July 15 and they don’t know yet the way forward, he said.

“It’s my 10 years in the Commission and I’ve learned that I need to be patient,” said Rys. “I think the dynamic is there — so let’s see.”